ObjectiveTo evaluate the safety and efficacy of urinary kallidinogenase for recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolytic treatment in patients with acute cerebral infartion MethodsA randomized control study was applied. All 44 patients with acute cerebral infartion were randomized 1:1 to the experimental group (22 cases) and the control group (22 cases). Patients were administrated rt-PA(0. 9 mg/kg)in control group, and patients were given urinary kallidinogenase by intravenous drip (0.15 PNAU/d, for 7 days) after rt-PA intravenous thrombolytic treatment (0.9 mg/kg)in experimental group. The main evaluation index was the incidence of symptomatic intraeerebral hemorrhage within 24 hours, and the secondary assessing items were NIHSS and BI. ResultsThere was 1 case (4.6%) with symptomatic intracerebral hemorrhage in the experimental group and 2 (9.1%) in the control group (X2 =0.00, P= 1.000),and reinfarction rate showed a decreasing tendency in experimental group (18.2% vs. 31.8%, X2=1.091,P=0.296). Compared with the control group, the NIHSS scores were significantly lower 1,21,90 days after thrombolytic therapy (t=2.119, 2.913, 2.187);P=0.041, 0.0 06, 0.042),and the BI scores were obviously higher at 90 days after thrombolytic therapy in experimental group(t= 2.39,P= 0.012). ConclusionsWithout increasing the risk of intracerebral hemorrhage, urinary kallidinogenase may improve the curative effect for rt-PA intravenous thrombolytic treatment in patients with acute cerebral infartion

Antibodies, Viral ; blood ; Humans ; SARS Virus ; immunology ; Severe Acute Respiratory Syndrome ; immunology ; T-Lymphocytes, Cytotoxic ; immunology

Objective To analyze the corneal flap thickness in laser in situ keratomileusis(LASIK) using Moria M2 microkeratome and to identify the related factors. Methods Sixty patients with LASIK were divided into two groups: M2 90 group,using the Moria M2 90 microkeratome,n=30;M2 110 group,using the Moria M2 110 microkeratome,n=30.All were performed on both eyes with the right one treated first.Subtraction pachymetry was used to measure corneal flap thickness which was analyzed statistically with the data including age,preoperative corneal diameter,curvature,corneal thickness and refraction. Results In the 30 patients of M2 90 group,the mean corneal flap thickness of right eye and left eyes were(128.03?12.03)?m(105~156 ?m) and(123.40?12.38) ?m(92~147 ?m),respectively,and the corneal flap thickness were statistically different between the right and left eyes(P

Objective:To investigate the clinical value of decompression in the treatment of jaw large cystic lesions.Methods:42 patients with jaw large cystic lesions were treated with decompression.Imaging examination was taken and compared before and after the treatment.The influence of frequency of cyst cavity washing on the effect of decompression was observed.Results:3 moths after de-compression the border of the cyst cavity became ambiguous and the size of the cavity reduced.12 months after decompression the size of cyst cavity was stable,when second surgery was taken to remove the left cyst wall.There was no recurrence of the cystic lesion after 1 ~2 year follow-up.Cyst cavity was washed everyday,but the effect and treatment course were not influenced by the daily washing times.Conclusion:Decompression is effective in the treatment of the jaw large cystic lesions.

BACKGROUND:Old femoral neck fractures with senile osteoporosis have more surgical difficulties.There are a lot of intraoperative and postoperative complications and long-term effects are poor.OBJECTIVE:To explore the clinical outcomes of hip arthroplasty in patients with old femoral neck fractures with senile osteoporosis.METHODS:From October 2012 to July 2014,20 patients with old femoral neck fractures and senile osteoporosis were enroled in this study.Posterolateral approach was used to perform hip arthroplasty.Of them,14 patients received primary total hip arthroplasty with biological prosthesis,and 6 patients were subjected to semi-hip arthroplasty with straight shank cylindrical renovated biological prosthesis.RESULTS AND CONCLUSION: The patients were folowed up for 3 to 24 months.Harris score was apparently increased after arthroplasty in patients with old femoral neck fractures and senile osteoporosis compared with pre-arthroplasty.Postoperative radiographs revealed that femoral stem biological fixation was good.Bone fixation was visible in radiographs at 3 months after arthroplasty.These findings suggested that old femoral neck fractures and senile osteoporosis could be treated with hip arthroplasty.To select the type of prosthesis and surgical methods according to the femoral calcar-medulary cavity ratio in patients with old femoral neck fractures and senile osteoporosis can effectively restore the function of hip joint.

Objective:To investigate the effects of Nano-chitosan rhBMP-2 Gel(NCS/BMP-2 Gel)on the repair of mandibular de-fect.Methods:NCS/BMP-2 Gel and NCS Gel were prepared and respectively injected into the subcutaneous space on both sides of dorsum of 9 rats.3 rats were respectively sacrificed 10,20 and 30 d after injection.The subcutaneous nodules were histologicaly ex-amined.Mandibular defect was made in 54 SD rats and the rats were divided randomly and into 3 groups(n=18):NCS/BMP-2 Gel was implanted into the defects in group 1,NCS Gel in group 2,no injection in group 3.Animals were sacrificed 3,6 and 9 weeks after transplantation.X-ray examination,pathologic observation were conducted.Results:Subcutaneous nodules were found in both sides of the rat dorsum.The residual mandibular defect area in study group 1 was apparently smaller than that in group 2 and 3(P<0.05). More new bone formation was observed in the gel injected area in group 1 than in group 2 and 3.Conclusion:Nano-CS/BMP-2 Gel is biocompatible and can accelerate the healing of mandibular defect.

ObjectiveTo investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions.MethodsTotally 45 patients with thyroid solid lesions underwent CEUS examination.The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed,and the results were compared with pathology.ResultsCEUS diagnosed 31 benign lesions and 14 malignant masses.The diagnostic accordance rate of CEUS was 93.75％ (30/32) and 92.31％ (12/13) for benign and malignant lesions respectively.In 31 benign lesions,27 (27/31,87.10 ％) showed entire homogeneous enhancement,4 (4/31,12.90％) presented inhomogeneous enhancement.In 14 malignant masses,1 (1/14,7.14 ％) showed homogeneous hypoechoic enhancement,12 (12/14,85.71％) presented inhomogeneous hyperechoic enhancement and 1 (1/14,7.14％) presented non-enhancement.ConclusionCombined with two-dimensional grey scale ultrasound and CDFI,CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions,therefore helps to differentiate benign and malignant thyroid lesions.

BACKGROUND:Under co-culture conditions, mesenchymal stem cel s could regulate osteogenic differentiation and osteogenesis of osteoblasts. OBJECTIVE:To observe the osteogenic efficiency of osteoblastic precursor cel s co-cultured with undifferentiated bone marrow-derived mesenchymal stem cel s, umbilical cord-derived mesenchymal stem cel s, or placenta-derived mesenchymal stem cel s in mineralization medium. METHODS:Adipose-derived stem cel s were induced in osteogenic differentiation medium for 7 days before being indirectly co-cultured with undifferentiated mesenchymal stem cel s isolated from different tissues (bone marrow group, umbilical cord group and placenta group) in Transwel plates. Induced adipose-derived stem cel s cultured alone served as control group. At different experimental intervals, quantitative analysis of alkaline phosphatase activity and calcified matrix was preformed to observe the effects of mesenchymal stem cel s from different sources on the osteogenic efficiency of induced adipose-derived stem cel s. RESULTS AND CONCLUSION:Expression of alkaline phosphatase was significantly higher in different experimental groups than the control group (P<0.05), and it was also higher in the bone marrow group than the umbilical cord and placenta groups (P<0.05). Quantitative analysis of calcified matrix revealed that the experimental groups were significantly higher than the control group (P<0.05);and in experimental groups, the umbilical cord group was higher than bone marrow group and placenta group (P<0.05). These findings indicate that the osteogenic efficiency of induced adipose-derived stem cel s is improved dramatical y under co-culture conditions.

Objective To explore the value of free anterolateral thigh flaps in the reconstruction of maxillofacial defects after resection.Methods Patients were recruited from January,2008 to March,2016 in the Department of Oral and Maxillofacial Surgery of Nanjing University.All patients sunder when reconstructive surgery employing anterolateral thigh myocutaneous flaps follow-up of 3 months to 84 months after operation.Results Among 422 cases,survived completely with satisfied configuration,the survival rate was 98.6％.Postoerative vessel thrombosis occurred in flaps,21 patients required operative exploration in the perioperative period including 10 flaps with thrombotic events and 11 flaps with venous thrombosis were complete survival after the salvages,and 6 flaps were failure.The mean follow-up was 36.5 months (range:3 to 84 months).Conclusion The free anterolateral thigh flap is an ideal choice for reconstruction of maxillofacial defects,as it has many advantages such as abundance volume,easily molding and adjusting the thickness,possessing,long vascular pedicle,composition need to be adjusted according to defects,easily concealed donor site,and little donor site complications and malformation.

Objective We investigated the value of endoscopic evacuation and craniotomy of the hypertensive in?tracerebral hemorrhage to determine which methods are more suitable for the patients. Methods One hundred twenty pa?tients with hypertensive intracerebral hemorrhage participated this study. They were divided into classic surgical evalua?tion group (n=60) and endoscopic surgical evaluation group (n=60) according to their corresponding surgery strategies. Each patient was assessed by the preoperative Glasgow Coma Scale (GCS), the mean rate and time of hematoma evacua?tion from onset to operation, the postoperative GCS, the mean time of admission in neuro-intensive care unit (NICU) and Glasgow Outcome Score (GOS) at 3 month after surgery. Results The continuous (≥3 months) follow-up surveys were all completed by 120 patients. There was no statistical difference in clinical data before operation between two groups (P>0.05). However, clearance of hematoma was much faster and more efficient in endoscopic surgical group than in classic surgical evaluation group (1.5 ± 0.4 vs.3.9 ± 0.6 h, P<0.01; 95.84 ± 2.72% vs.87.48 ± 7.84%, P<0.01). The GCS scores were 10(6,12),12(8,13) and 13(10,13) in endoscopic surgical group whereas were 6(5,9),7(5,11).8(5, 12) in craniotomy group at 1,3 and 7 d followed operation. GCS scores were higher in surgical group than in craniotomy group at all time points (P<0.01). In addition, patients receiving endoscopic treatment showed a shorter NICU admission time than those receiving craniotomy (3.55±4.21d vs. 9.10±4.72d, P<0.01). The intracranial infection and hypostatic pneumonia were sig?nificantly lower in endoscopic than in craniotomy surgery group (0 vs.6 cases; 5 vs. 41 cases, P<0.05). The endoscopic treatment significantly improved the GOS score compared with craniotomy [3(3, 4)vs. 2(2, 3)] (P<0.01). Conclusion Endoscopic evacuation of hematoma for hypertensive intracerebral hemorrhage is efficient and minimally invasive, which is superior to craniotomy.